Bronchial asthma(中国医大7年制《内科学》课件).ppt

Bronchial asthma Department of respiration Kong Lingfei Background of asthma Prevalence ：in the world: 1.6 hundred million in China: 1～3 ％ in Shenyang: 1.24 ％（1999） GINA: Global Initiative for Asthma（1994） WHO/HLBI Bronchial asthmatic diagnosis guideline (1997） Chinese Medical Academy Definitions of asthma Chronic airway inflammation Broncho-hyperresponsiveness, BHR Airflow limitation Mechanism: allergy theory antigen antigen ↓ ↓again atopy→IgE antibody→mast cells, basophils ↓ histamine inflammatory media LTs ↓ PAF ECP immediate asthmatic reaction, IAR ↓ bronchial smooth muscle spasm airway narrow Mechanism: never-receptor disorder theory adrenergic and cholinergic nerous systems, AC non-adrenergic and non-cholinergic nerous systems, NANC AC: α1-receptor、M1-、M3-receptors excitement NANC：PS-receptor ↓ bronchial smooth muscle contraction AC: β-receptor、M2-receptor excitement NANC: VIP receptor ↓ bronchial smooth muscle dilation asthmatic airway: a1、M1、M3、PS↑/ β 、M2、VIP↓ Mechanism: airway inflammation theory antigen ↓ allergic airway inflammation, AAI ECP ↑ MBP inflammatory cells →inflammatory media LTs EOS ↓